Health Professional Schools Research Articles

Exploring the Influence of an Interprofessional Student-Run Clinic on Matriculation to Health Professional School: A Retrospective Cross-Sectional Study

Background: Projected demographic trends in the United States suggest increasing racial and ethnic diversity. It is important that the healthcare workforce reflects these trends to reduce healthcare disparities among underserved populations. For example, concordant backgrounds between patients and providers improve communication and increase probability that patients seek and receive healthcare among marginalized populations. Building in curricular opportunities to connect with the underserved community is one way to recruit students from diverse backgrounds into this pipeline that will lead to a diverse workforce in healthcare. The objective of this study was to assess the influence of an interdisciplinary student-run clinic (SRC), which focuses on caring for underserved and vulnerable populations, on students’ decisions to matriculate in four health professional programs (medical, occupational therapy, pharmacy, and physician assistant) at a single institution.
 Methods: In this retrospective cross-sectional survey study, we examined factors influencing first-year students’ decisions to attend a private university in a large metropolitan area. The primary outcome was students’ self-reported ratings of the university’s SRC as a factor in their matriculation decisions. Two-tailed Mann-Whitney-U tests was applied to compare the relative importance of SRC on matriculation. Free response data were evaluated by a qualitative content approach.
 Results: A total of 419 students completed the survey (73% completion rate) across the 4 programs. We found that underrepresented minorities in medicine (URM) (p < 0.05) and first-generation (p < 0.01) students rated the importance of an SRC on their matriculation decision significantly higher than non-URM and non-first-generation students.
 Conclusions: Our findings suggest that the presence of an SRC may positively impact matriculation decisions and diversification of the student body across certain health professional disciplines.

A continuing professional development imperative? Examining trends and characteristics of health professions education doctoral programs.

Despite the long-standing faculty development initiatives for improving teaching skills in the health professions, there is still a growing need for educators who are formally trained in educational theory and practice as health professions schools experience dramatic demand and growth. Graduate programs in health professions education (HPE) provide an avenue for health professions' faculty continuing professional development to enhance their knowledge and skills for teaching and curriculum leadership roles. There has been a proliferation of certificate, master's, and doctoral programs in HPE over the last two decades to respond to the growing need for well-prepared faculty educators and program leadership. The purpose of this study was to identify and describe current HPE doctoral programs in United States (U.S.) and Canada. The study first examined doctoral programs in HPE identified in earlier studies. Next, we searched the literature and the web to identify new doctoral programs in the U.S. and Canada that had been established between 2014, when the prior study was conducted, and 2022. We then collated and described the characteristics of these programs, highlighting their similarities and differences. We identified a total of 20 doctoral programs, 17 in the U.S. and 3 in Canada. Of these, 12 programs in the U.S. and 1 program in Canada were established in the last 8 years. There are many similarities and some notable differences across programs with respect to degree title, admission requirements, duration, delivery format, curriculum, and graduation requirements. Most programs are delivered in a hybrid format and the average time for completion is 4 years. The workforce shortage facing health professional schools presents an opportunity, or perhaps imperative, for continuing professional development in HPE through certificate, master's, or doctoral programs. With the current exponential growth of new doctoral programs, there is a need to standardize the title, degree requirements, and further develop core competencies that guide the knowledge and skills HPE graduates are expected to have upon graduation.

Feedback Type on Abdominal Drawing-In Maneuver Performance: Further Motor Control and Motor Learning Considerations

<h3>Research Objectives</h3> To compare effects of verbal, tactile-verbal and visual feedback on muscle activation of the trunk stabilizers relative to trunk-extremity movers during Abdominal Drawing-In Maneuver (ADIM). <h3>Design</h3> The study employed a quasi-experimental pre-post intervention design. <h3>Setting</h3> The study was conducted at School of Health Professions, SUNY Health Sciences University. <h3>Participants</h3> A convenience sample of 54 healthy participants between18-49 years of age were equally divided among three feedback groups: Verbal, Tactile-Verbal and Visual. <h3>Interventions</h3> All participants were instructed similarly to perform the ADIM prior to receiving intervention 2x/week over a four-week period. The feedback provided during interventions was delivered concurrently but feedback types differed amongst the groups. Verbal group received intermittent feedback based upon observance of substitution patterns. Tactile-verbal group received feedback every trial upon palpation of Transverse Abdominis. Lastly, Visual group received feedback every trial using a pressure biofeedback unit. <h3>Main Outcome Measures</h3> The percentage of maximum voluntary isometric contraction of rectus abdominis (RA), multifidus (MF), erector spinae (ES), and hamstrings (HS) as outcome measures were acquired using surface electromyography. A two-way factorial ANOVA with bootstrapping allowed comparison of pre-post difference scores across the interaction of feedback and muscle groups. <h3>Results</h3> HS activation decreased in the tactile-verbal group, relative to an increase in subjects given visual feedback. Furthermore, in the verbal group, HS activity increased relative to a decline in RA; and in the visual group, HS activity increased relative to a decrease in MF. However, no pre-post changes were seen across muscles with tactile-verbal feedback. <h3>Conclusions</h3> Although tactile-verbal feedback did not increase MF recruitment, it recruited less HS activity than verbal and especially visual feedback. Increases in HS recruitment may reflect boredom of simple task or feedback dependency. <h3>Author(s) Disclosures</h3> The authors have no disclosures.

Cigarette Use Among Older Adults: A Forgotten Population.

AffiliationsBethea A. Kleykamp is owner and principal of BAK and Associates, Baltimore, MD. Jessica A. Kulak is with the Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY.

Health professions school applicant experiences of discrimination during interviews

Background Bias pervades every aspect of healthcare including admissions, perpetuating the lack of diversity in the healthcare workforce. Admissions interviews may be a time when applicants to health profession education programs experience discrimination. Methods Between January and June 2021 we invited US and Canadian applicants to health profession education programs to complete a survey including the Everyday Discrimination Scale, adapted to ascertain experiences of discrimination during admissions interviews. We used chi-square tests and multivariable logistic regression to determine associations between identity factors and positive responses. Results Of 1115 respondents, 281 (25.2%) reported discrimination in the interview process. Individuals with lower socioeconomic status (OR: 1.78, 95% CI [1.26, 2.52], p = 0.001) and non-native English speakers (OR: 1.76, 95% CI [1.08, 2.87], p = 0.02) were significantly more likely to experience discrimination. Half of those experiencing discrimination (139, or 49.6%) did nothing in response, though 44 (15.7%) reported the incident anonymously and 10 (3.6%) reported directly to the institution where it happened. Conclusions Reports of discrimination are common among HPE applicants. Reforms at the interviewer- (e.g. avoiding questions about family planning) and institution-level (e.g. presenting institutional efforts to promote health equity) are needed to decrease the incidence and mitigate the impact of such events.

Violência contra crianças e adolescentes: intervenções multiprofissionais da Atenção Primária à Saúde na escola

ABSTRACT This excerpt of a master’s thesis aims to describe the construction of proposals for the prevention, combat, and attention to intrafamily and school violence against child and adolescent students in a suburban district of a municipality in the inland region of Bahia, Brazil. A qualitative, descriptive, exploratory study was conducted through action research. The social stakeholders of the research were the school community, the family, and health professionals. Data were collected by systematic observation, conversation circles, and seminars adopted for situational diagnosis and the development of interventions. Data was interpreted through content analysis. The activities revealed the relevance of the work developed in intersectoral and multidisciplinary qualified network, resulting in behavioral changes of adolescents at school and in the family, their leadership in educational workshops for a peace culture, the implementation of a conflict mediation space at school, the establishment of a physical activity project, drawing parents closer to the school, and raising the awareness toward better possibilities of non-violent domestic education. We conclude that the interventions initiated a movement of change of practices and dialogue of the several district services, resulting in a gradual construction of peace territories in the school and the community.

Biden administration provides more resources, supports for school MH needs

The field recently witnessed promising investments in school‐based mental health, including more than $300 million, via awards and grants, for health professionals in schools and in emergency departments (EDs). The bulk of the funding would be provided through the Bipartisan Safer Communities Act (BSCA), a firearm regulation and mental health bill that was passed this summer by Congress and signed into law by President Biden.

Qualitative evaluation of postdoctoral trainee and faculty advisor experiences within a research-intensive school of pharmacy

BackgroundPostdoctoral trainees play a vital role in securing grant funding, building alliances, and mentoring graduate students under the guidance of a mentor who can help develop their intellectual independence. However, the experiences of postdoctoral trainees, particularly within health professions schools, is largely unexplored. The purpose of this study was to investigate the experiences of postdoctoral trainees and faculty advisors at a public four-year school of pharmacy and identify areas of opportunity to improve postdoctoral training.MethodsFocus groups and interviews were conducted to elicit participants’ experiences, perceptions, and suggestions for improvement. Stakeholder groups included postdoctoral trainees and faculty who serve as postdoctoral advisors. Thematic coding was used to identify semantic themes, and summaries of participant perceptions were generated. Results were mapped to the identity-trajectory framework.ResultsParticipants described various experiences related to intellectual growth, networking opportunities, and institutional support. In addition, participant agency was critical for developing career goals and navigating transitions. COVID-19 introduced unique challenges associated with transitioning to remote work and managing goals/motivation. Areas of opportunity were identified, such as improving infrastructure, enhancing mentoring, and enhancing communication.ConclusionPostdoctoral trainees play a critical role in the success of academic institutions. Scholarly endeavors that explore postdoctoral experiences, specifically those utilizing qualitative methods, can help pharmacy education better understand and meet the needs of postdoctoral trainees and faculty advisors. This study provides insight into the experiences of postdoctoral scholars and provides evidence for improving these training programs in schools of pharmacy.

Sex differences in factors associated with neck pain among undergraduate healthcare students: a cross-sectional survey

BackgroundNeck pain is widespread among students in healthcare-related fields. Although neck pain is more prevalent in females, since most research involves mixed-sex samples we know very little about sex differences in contributors to neck pain. Thus, this study sought to explore sex differences in the risk factors for neck pain in this high-risk population.MethodsThis cross-sectional study was conducted in China in 2021 and included a sample of 1921 undergraduate healthcare students (693 males, 1228 females) from 7 health professional schools at Fujian Medical University. We collected data on neck pain symptoms, demographics, behavioral and psychological factors. Multiple regression analysis was conducted to examine sex differences in the risk factors of neck pain.ResultsThe overall prevalence of neck pain was 41.6% with female students having a higher prevalence than male students (44.4% vs. 36.7%, respectively). The adjusted analyses showed that self-study time ≥ 6 h/day (OR = 1.44, 95% CI:1.13-1.83), flexed neck posture >20 degrees (OR = 2.19, 95% CI: 1.28-3.74), static duration posture >2 h (OR = 1.42, 95% CI: 1.02-1.97), and psychological distress (high: OR = 2.04, 95% CI:1.42-2.94; very high: OR = 2.50, 95% CI:1.57-3.74; respectively) were independent factors for neck pain in females. Among males, self-study time ≥ 6 h/day (OR = 1.43, 95% CI: 1.02-2.01) and psychological distress (moderate: OR = 2.04, 95% CI:1.28-3.25; high: OR = 2.37, 95% CI:1.49-3.79; very high: OR = 2.97, 95% CI:1.75-5.02; respectively) were significant risk factors for neck pain.ConclusionsThese findings suggest that the risk profiles of neck pain differ between females and males. The modifiable risk factors for neck pain, such as prolonged self-study time and elevated psychological distress, as well as poor posture among females, could be targeted through health promotion interventions in university settings.

Dental school pathway programs: Best practices for increasing workforce diversity.

The chronic underrepresentation of racial/ethnic minority practitioners in the U.S. health professions workforce is an oft-cited factor for disparities in health and health-care access affecting communities of color. As non-White providers are more likely to serve uninsured patients and practice in underserved areas, pathway/pipeline programs have been used for many years to increase the numbers racial/ethnic minorities in the health professions workforce. These programs target precollege, college, and postbaccalaureate students from historically underrepresented minority (HURM) groups (defined as African American/Black, Hispanic/Latino, and Native American students) to stimulate interest in health professions careers and provide academic support, mentoring, enrichment experiences, and other resources to facilitate their successful admission to and completion of health professions school and entry into the workforce. This article examines dental pathway programs to identify best practices for increasing enrollment of HURM students in dental school and their successful entry into the dental workforce-as evidenced in the academic literature.

P03-01 The effect of device-free recess on schoolchildren's physical activity and social interaction

BackgroundIn Denmark, 74% of the 11-15-years-old children do not reach national recommendations on physical activity and 6% (∼20.000 children), experience unwanted loneliness. School recess provides a unique opportunity for children to be active with others and form good relations. However, studies have found that many children perceive electronic devices such as mobile phones, tablets and computers as a key barrier for engaging in active play with other children during recess. These findings are based on perceptions from qualitative data. To our knowledge, no studies have investigated the effect of device-free recess on children's recess behaviour. This knowledge is asked for by school boards, health professionals and politicians to inform future policies and actions. Therefore, the aim of this intervention study is to investigate the effect of device-free recess on schoolchildren's physical activity and social interaction.MethodsDuring April-June 2020 device-free recess environments will be implemented at seven Danish schools. Children will be asked to place their mobile phones, tablets and computers in locked? device-hotels? during recess for a four-weeks intervention period. Among a cohort of 900 children from Grades 4-6 (10-13 yrs.) physical activity and social interaction during recess will be measured before and during the last intervention week using questionnaire and systematic observation (SOPLAY). All data will be analysedusing multilevel modelling for repeated measures to see pre- versus post intervention changes.ResultsSince the data collection will be carried out in spring 2020, results cannot be presented yet. However, the results will be ready for the HEPA conference in September 2020. Our hypothesis is that the children will increase their physical activity level and social interaction. However, we will also look into recess behaviourpre- and post-intervention across different subgroups of children e.g., gender, age, screen and physical activity habits prior intervention.ConclusionsThe study will be a crucial contribution to the limited knowledge in this field, and in line with the strategy of HEPA, the ambition is to provide evidence-based knowledge on which to base future decisions to improve the everyday conditions for schoolchildren's physical, social and mental development and health.

Understanding the Turkish adolescents' weight perception: A cross-sectional study.

Adolescence is regarded as a period in which adolescents go through a number of physical changes in appearance and a transition from childhood to adulthood. Throughout this transitional period, adolescents become more concerned with their size and weight. The aim of this study was to determine the self-perceived weights status of adolescents 11-19 years old. A cross-sectional study was conducted with a sample of 1459 students, aged 11-19 years, in Turkey. Anthropometric measurements of weight and height were measured with appropriate tools and adolescents' self-perception of weight status was assessed by the Figure Rating Scale. Nearly half of the adolescents had misperceptions about their weight status (49.6%). There was a significant association between body mass index (BMI) z-score categories and weight status misperception. Overall, the weight status misperception was more common among the girls than boys. Misperception of weight status in adolescent should take into account the following: development of intervention programs aimed at screening weight and weight perception, empowering young people to have accurate weight status perception, and raising awareness of the issue in school health professionals.

Congress Passes First Significant Gun Safety Bill in Decades

Congress Passes First Significant Gun Safety Bill in Decades

Ethical Considerations in Precision Medicine and Genetic Testing in Internal Medicine Practice: A Position Paper From the American College of Physicians.

This American College of Physicians position paper aims to inform ethical decision making for the integration of precision medicine and genetic testing into clinical care. Although the positions are primarily intended for practicing physicians, they may apply to other health care professionals and can also inform how health care systems, professional schools, and residency programs integrate genomics into educational and clinical settings. Addressing the challenges of precision medicine and genetic testing will guide ethical and responsible implementation to improve health outcomes.

Restructuring Interprofessional Education: A Student-Driven Strategic Plan.

To the Editor: Research has consistently shown that interprofessional education (IPE) improves patient-centered care and outcomes. 1–3 Specifically, newer research has identified that student leadership in IPE leads to improved participation among peers and enhances sustainability, thus leading to improved interprofessional education overall. 4 The IPE Student Advisory Committee (SAC) is a student-run committee that serves as a collaborative community for all the health professional schools and officially recognized IPE organizations at the University of Michigan. For the 2020–2021 academic year, the SAC cochairs determined there was a need to improve the IPE experience, increase student engagement, and improve communication. The SAC aimed to improve 3 priority areas: structure, education, and wellness. For structure, the committee hoped to add an additional cochair and divide the cochairs into different priority areas. The cochairs created an IPE representative program in which students who were passionate about IPE were selected from each health school to serve as members of SAC and act as liaisons between SAC, their school, and the other health professional schools. SAC successfully recruited 12 student representatives who have seen support for their IPE endeavors grow. They now have plans to expand courses, increase funding, and improve interprofessional opportunities for their fellow students. For education, students wanted to see more experiential-based learning, so a workgroup of faculty and SAC cochairs worked to create a new IPE experience—the Longitudinal Interprofessional Family-Based Experience (LIFE). LIFE connected interdisciplinary student teams with patients and families managing chronic illnesses. It launched this past semester with positive feedback from participants who hope to continue. For wellness, the SAC cochairs partnered with a representative from the University of Michigan Wellness Office and convened a Wellness Task Force that works directly with the Wellness Office representative to improve communication about different wellness offerings. Organizational change can be a difficult undertaking, but it is especially crucial to execute well when working within interprofessional teams. As a fairly new organization that serves as a role model for IPE excellence, SAC had the opportunity to revolutionize how interprofessional organizations function and achieve goals to improve the interprofessional experience for all students at the University of Michigan. The cochairs aim to share their implementation of structure-based initiatives in hopes that other medical training programs can follow. They want to educate fellow medical trainees on different ways they can have an impact on their institutions’ IPE programming.

Battle for the Faculty's Soul.

As we interviewed faculty candidates, each asked a similar question: What was the most challenging part of becoming a faculty member in an academic medicine setting? I know the answer without having to think because the scar from the battle for my faculty soul is still relatively fresh. Forming my identity and a picture of what I wanted my work as a member of the faculty to be and mean was (and is) the most challenging aspect of my life as a faculty member. From my first day, I heard rumblings that the institution was embarking on a mission to place a greater emphasis on scholarly work from all faculty—including those in the school of health professions. I observed that the faculty were uncomfortable with this transition and argued the importance of teaching as the focus of being a faculty member. A natural helper at heart (I am a physician assistant after all), I committed myself to teaching and education and labeled any and all other pursuits as distraction and noise. Scholarly pursuits were selfish—existing solely for the game of self-advertising that is promotion and tenure. The game of academia. I eschewed these pursuits as beneath the nobility of being an educator. But as I developed in my facultyhood, I grew increasingly curious about pedagogy. Like a young wizard discovering Diagon Alley, I could sense a world beyond this one that called to my sense of wonder. That call was too strong for me to resist. I started to explore the science of teaching and learning and as I embarked on writing my first manuscript, I noted creative parallels to my teaching practice that ignited flow states and left me wanting to practice the craft of scholarship. I began to take on more projects and explore issues outside my designated work time. Several times, colleagues warned me I was taking on too much and that it was a recipe for burnout, and I worried they might be right. Simultaneously, the rumble between faculty and the leadership push for scholarly work reached a nadir. The conflict over scholarly work felt almost oppressive to me. So too did the conceptualization of my work as a 3-legged stool with education, scholarship, and clinical work as the base—as distinct entities that require siloed time and attention. So often, we are pushed to imagine opposite forces in our lives being in balance. We are often confronted with the notion of work–life balance, for example. And here specifically, I was confronted with the notion of balancing my educational practice against my scholarly work. The premise I perceived was that one would take from the other and that they could not both exist in harmony. Further reflection made me think about reframing this battle of balance. Why a battle at all? Why not conceptualize our work as academics as a garden with scholarly work and educational excellence as inhabitant plant species? The garden will have seasons where one of the inhabitants will need more attention than the other or be more prevalent than the other. But the 2 exist in the space in symbiosis. If a faculty member works to ensure that one nourishes the other, the garden is that much more resilient and beautiful. Thus, the real work of a faculty is in that space of intentional craftsmanship. Six years after the start of my journey as a faculty member, I arrived at this peaceful overlook. During those 6 years, I felt torn in 2 by what was presented to me as a battle for the 2 parts of who we are as educators in an academic institution. What I realized was the noise was not the battle, the noise was outside forces trying to dictate what should be planted in the garden of my work. When I listened to what inspired me, I heard what truly mattered and was able to plan what I thought the garden should look like and how each part might synergistically contribute to my overall well-being and satisfaction as a faculty member. More importantly, I learned that this synergy could be my contribution to making the world a better place. When faculty members open themselves up to the idea that the work we do in seemingly different realms can actually enhance our practice, we arguably do our greatest service to the development of others’ gardens.

Flexible, short-duration outreach sessions in the human anatomy laboratory provide authentic, humanistic experiences.

Anatomy laboratories can provide rich opportunities for outreach to K-12 and college students interested in pursuing careers in health, medicine, or science. At the University of Missouri, the Department of Pathology and Anatomical Sciences has designed flexible, one-hour interactive sessions that typically cover basic anatomical concepts using whole-body donors. In order to evaluate whether short-duration programs were impactful in increasing enthusiasm for anatomy and the health professions sciences, we used mixed methods to study participant experience covering three topics: (1) enthusiasm for anatomy, (2) interest in pursuing a career in healthcare professions, and (3) perception of the importance of whole-body donation. The same questions were asked pre- and post-session, and the post-session survey had additional questions related to student satisfaction. Quantitative analyses showed an increased interest in anatomy and appreciation for whole-body donation following the session. Students also perceived that they had a better understanding of the body and what it would be like to attend a health professions school. Thematic analysis revealed an appreciation for contextualizing the size, position, and hands-on feel of anatomical structures, and emphasized that students felt that they understood the body better after having seen a donor's anatomy. This work shows that short-duration, flexible outreach sessions involving whole-body donors can provide students with a rare opportunity to confirm their contextual understanding of anatomy, and provide students with an authentic, and humanistic experience.

Exploring cognitive apprenticeship and teaching practices in pharmacy education

Health professions schools in the United States and internationally have engaged in curricular changes to better prepare students for the future of health care. However, designing or selecting evidence-based teaching activities can be a challenge. Research suggests the Cognitive Apprenticeship theory is an effective framework for the health professions to inform instruction design, yet these studies have mainly focused on the clinical setting and not the didactic learning environment. This study used qualitative methods to explore the Cognitive Apprenticeship framework in the didactic learning environment and the teaching practices that pharmacy faculty used to explicate their expert thinking to students. Faculty were observed using all four Cognitive Apprenticeship dimensions (ie, Content, Sequencing, Methods, Sociology) in their teaching practice. Patterns were observed in the data revealing complex, short and sometimes spontaneous teaching practices that faculty used to promote learning.

Applying Entrustable professional activities to prescription verification activities in two skills-based laboratory courses

Background and purposePrescription verification is a practice-ready expectation for pharmacy graduates. Entrustable professional activities (EPAs) should be applied to practice-ready skills-based assessments. This manuscript describes the technique of two different institutions in assessing prescription verification aligned to the Practice Manager domain of the Core EPAs as defined by the Academic Affairs Standing Committee 2015–2016 report. Educational activity and settingVirginia Commonwealth University School of Pharmacy (VCU) and University of Maryland Eastern Shore (UMES) School of Pharmacy and Health Professions describe their two methods of evaluating prescription verification with the EPA Practice Manager domain. Each program performed the activities in first-year skills-based laboratory courses. FindingsFulfillment of a medication order was framed into law, medication label, and dispensing accuracy. Both institutions' assessments were high-stakes assessments that included errors. Overall, the majority of both programs' students passed with the institution-specified level of entrustment on their first attempt, with 75.9% to 77.5% of VCU students per each assessment and 74.5% for UMES. The lowest performance, Level 1, assessment scores for the first attempt were 10% for VCU and 2% for UMES, requiring repetition of the assessment for those students. All students achieved a minimum of Level 3 during the reassessments. SummaryDifferent assessment techniques may arise from program design and institutional resources. However, it is important to ensure EPAs are met for all students in prescription verification. Faculty should consider their own verification activities and level of trust expected for students to meet prior to pharmacy practice experiences.

Longitudinal study of grit among pharmacy students: Impact of cohort and professional year

IntroductionWhether grit changes over a student's enrollment in health professions school is unknown. We aimed to measure grit across 13 cohort-years of students in a four-year doctor of pharmacy (PharmD) program. MethodsWe administered the Short Grit Scale (Grit-S) to first-year (P1), second-year (P2), third-year (P3), and fourth-year (P4) PharmD students between 2016 and 2019. There was no intervention aimed at increasing grit. ResultsA total of 1381 responses were recorded across 624 students (86.5% response rate). Across all graduation cohorts, Grit-S scores significantly decreased by an average of 0.087 points from P1 to P2 (P = .004), increased significantly from P2 to P3 by 0.09 points (P < .001), and nominally increased from P3 to P4 by 0.023 points (P = .45). Between cohort differences in paired Grit-S scores only differed significantly for P3 to P4 (P = .03) and P1 to P3 (P = .01) years. A mixed-effects linear regression model clustered on graduation cohort and individual student found that mean Grit-S scores in the P2 year were − 0.1 points lower than those in the P1 year (P < .001). However, differences between P3 and P1 (−0.04, P = .17) and between P4 and P1 (−0.03, P = .37) were not statistically significant. ConclusionsIn the absence of a specific intervention, statistically significant changes in Grit-S scores occur over the course of a pharmacy school curriculum. The P1 year may be associated with a decline in grit, although by the P4 year Grit-S scores return to baseline.